Chapter 67: Tuberculosis

Question 1

is a tubercle, appearing as calcified hilar lymph nodes

Answer 1

Ghon complex

Question 2

TRUE or FALSE: During dormancy (or latent infection), a positive tuberculin skin test detects the disease

Answer 2

TRUE (The skin test becomes positive 1 to 2 months after initial
exposure)

Question 3

The most common
extrapulmonary site of tuberculosis is?

Answer 3

lymphatic system - painless
lymphadenopathy (i.e., scrofula, cervical lymphadenitis)

Question 4

The most common method for screening for exposure to M. tuberculosis

Answer 4

Mantoux or Tuberculin skin test

Question 5

≥5-mm induration is positive in:

Answer 5

CHAPO -15

• Patients with Close contact with a tuberculosis-infected individual
• Patients with the Human immunodeficiency virus
• Patients with Abnormal chest radiograph suggestive of healed tuberculosis
• Patients with organ transplants and other immunosuppressed patients receiving the equivalent of prednisone >15 milligrams per day for >1 month

Question 6

≥10-mm induration is positive in patients not meeting the above criteria (>5mm induration) but who have other risks:

Answer 6

4 - CHIIR

• Children <4 y of age
• High-prevalence groups (immigrants, long-term care facility residents, persons in local high-risk areas)
• Injection drug users
• Patients with conditions that increase the risk of progression to active disease (silicosis; diabetes; carcinoma of the head, neck, or lung)

Question 7

most common chest radiograph finding in TB, especially in immunocompromised patients

Answer 7

normal chest radiograph

Question 8

World Health Organization endorses ___ for diagnosis of pulmonary and extrapulmonary tuberculosis

Answer 8

nucleic acid amplification test (NAAT)

Question 9

major adverse effect of INH

Answer 9

Hepatotoxicity

NOTE: serum transaminases are greater than five times the upper limit of normal or if serum bilirubin is >3 milligrams/dL, stop antituberculous medications.

Question 10

A unique finding in paradoxical reaction or immune reconstitution syndrome

Answer 10

Hypercalcemia

Question 11

Drug that can cause Thrombocytopenia

Answer 11

Rifampin/Rifapentine

Question 12

Define Multidrug-resistant tuberculosis

Answer 12

Multidrug-resistant tuberculosis is tuberculosis with isolates that demonstrate resistance to at least INH and RIF

Question 13

The most common extrapulmonary presentation in children

Answer 13

cervical lymphadenitis

Question 14

Pathognomonic ophthalmologic finding for miliary TB

Answer 14

Choroidal tubercles